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Pediatrics > Pediatric Pulmonology > Flashcards

Pediatric Pulmonology Flashcards

1
Q

What are the components of CHARGE syndrome?

A
  1. Coloboma of the eye
  2. Heart defect
  3. Atresia choanae
  4. Retarded groth and development or CNS abnormality
  5. Genital anomalies or hypogonadism
  6. Ear anomalies
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2
Q

[Diagnosis]

4/M
High fever
Sore throat
Drooling, neck slightly hyperextended

A

Acute epiglotittis

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3
Q

[Diagnosis]

3mos to 3 years
Stridor
Low grade fever
1-7 days prodrome
barking cough
hoarseness

responds to racemic epi

A

Viral Croup

Parainfluenza virus

CXR: Steeple Sign

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4
Q

[Diagnosis]

3-7 years
Onset is rapid (4-12 hours)
High grade fever
muffled voice, drooling

A

Epiglottitis

H. influenzae type B

CXR: Thumb sign/ leaf sign

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5
Q

[Diagnosis]

Sore and scratchy throat, nasal obstruction, rhinorrhea

prominent itching and sneezing, nasal eosinophilia

A

Allergic Rhinitis

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6
Q

[Diagnosis]

Sore and scratchy throat, nasal obstruction, rhinorrhea

unilateral foul smelling discharge, bloody nasal secretion

A

Foreign body in the nose

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7
Q

[Diagnosis]

Sore and scratchy throat, nasal obstruction, rhinorrhea

Headache, facial pain, periorbital edema, rhinorrhea for >2 weeks

A

Sinusitis

Co-amoxiclav x 14 days

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8
Q

[Diagnosis]

Sore and scratchy throat, nasal obstruction, rhinorrhea

persistent rhinorrhea with onset in the first 3 months of life (snuffles)

A

congenital syphilis

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9
Q

[Diagnosis]

Sore and scratchy throat, nasal obstruction, rhinorrhea

history of prolonged use of topical or oral decongestant

A

Rhinitis medicamentosa

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10
Q

[Diagnosis]

Sore and scratchy throat, nasal obstruction, rhinorrhea

Paroxysm of cough leaving the baby breathless and subconjunctival hemorrhages

A

Pertussis or whooping cough

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11
Q

Most common cause of sinusitis (organism)

A
  1. S. pneumoniae
  2. Non-typable H. influenzae
  3. M. catarrhalis
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12
Q

Sinuses present at birth

A
  1. Maxillary

2. Ethmoid

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13
Q

Sinuses that are pneumatized at 4 years old

A

Sphenoid

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14
Q

Sinuses that begin to develop at 7-8 years old

A

Frontal

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15
Q

What are the stages of pertussis?

A
  1. Catarrhal
  2. Paroxysmal
  3. Convalescent
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16
Q

What is the DOC for pertussis?

A

Macrolide (Erythromycin or Clarithromycin)

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17
Q

What is the period of communicability in pertussis?

A

From 7 days after exposure to 4 weeks after onset of typical paroxysms

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18
Q

What is the most common complication of acute nasopharyngitis?

A

Otitis media

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19
Q

When will you consider doing tonsillectomy in patients with recurrent strep pharyngitis?

A
  1. > 7 episodes in the previous year

2. >5 in each of the preceding 2 years

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20
Q

[Diagnosis]

Patient presents with signs and symptoms of upper respiratory obstruction

patchy and ragged tracheal column

A

bacterial tracheitis

Tx: Antibiotics

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21
Q

[Diagnosis]

Patient presents with signs and symptoms of upper respiratory obstruction

thumb sign

A

Acute epiglottitis

If vaccinated: S. aureus

In unvaccinated: Hib

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22
Q

[Diagnosis]

Patient presents with signs and symptoms of upper respiratory obstruction

subglottic narrowing

A

Croup or laryngotracheobronchitis

All levels of distress: Dexamethasone

Moderate to severe distress: Steroid + racemic epinephrine

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23
Q

[Diagnosis]

Patient presents with signs and symptoms of upper respiratory obstruction

Air trapping on the right lung with mediastinal shift towards the right lung

A

Foreign body airway obstruction

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24
Q

[Diagnosis]

Patient presents with signs and symptoms of upper respiratory obstruction

steeple sign

A

Croup of LTB

ll levels of distress: Dexamethasone

Moderate to severe distress: Steroid + racemic epinephrine

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25
[Classify asthma severity] ``` Daytime symptoms: <1x/week Nighttime symptoms: <2x/month PEFR: >80% PEFR Variability: <20% FEV1: >80% ```
Intermittent
26
[Classify asthma severity] ``` Daytime symptoms: >1x/week Nighttime symptoms: >2x/month PEFR: >80% predicted PEFR Variability: 20-30% FEV1: >80% ```
Mild
27
[Classify asthma severity] ``` Daytime symptoms: Affects daily activities Nighttime symptoms: > 1x/week PEFR: 60-79% PEFR Variability: >30% FEV1: 60-79% ```
Moderate
28
[Classify asthma severity] ``` Daytime symptoms: Limits daily activities Nighttime symptoms: >1x/week PEFR: <60% PEFR Variability: >30% FEV1: <60% ```
Severe
29
[Levels of asthma control] ``` Daytime symptoms: >2x/week Nighttime symptoms: Any Limitation of activities: none Reliever: >2x/week PEF or FEV1: <80% Exacerbation: one or more /year 1 in any week ```
Partly controlled Uncontrolled if 3 or more features of partly controlled asthma
30
[Diagnosis] patient is wheezing history of viral infection among family members. Patient is 2 years old.
Bronchiolitis
31
[Diagnosis] patient is wheezing Hx of atopy in the family. recurrent wheezing after mild viral infection or after exercise.
Bronchial asthma
32
[Diagnosis] patient is wheezing Wheeze heard loudest over the trachea. persistent wheezing never seems to go away.
Chondromalacia
33
[Diagnosis] patient is wheezing Absent breath sounds on the right lung. Patient is 3 y/o
Foreign body airway obstruction
34
[Diagnosis] Fever, cough, tachycardia Poorly nourished, unvaccinated with onset of rashes all over the body
Measles pneumonia
35
[Diagnosis] Fever, cough, tachycardia Patient has cystic fibrosis, or a CGD, burn patient, neutropenic
Pseudomonas
36
[Diagnosis] Fever, cough, tachycardia Patient is a teen, living in a dormitory, initial cough is non-productive
Mycoplasma
37
[Diagnosis] Fever, cough, tachycardia patient has his own aviarium in his home
Psittacocis
38
[Diagnosis] Fever, cough, tachycardia Eye discharge during the first 5-14 days of neonatal period
Chlamydia
39
[Diagnosis] Fever, cough, tachycardia extensive areas of hemorrhagic necrosis, irregular areas of cavitation, pneumatoceles, empyema, bronchopulmonary fistula
S. aureus
40
[Diagnosis] Fever, cough, tachycardia Diffuse infection with interstitial pneumonia, necrosis of tracheobronchial mucosa formation of large amounts of exudates, edema, local hemorrhage lymphatic vessels included
GABHS
41
[Diagnosis] Fever, cough, tachycardia local edema that aids in the proliferation of organism resulting in focal lobar involvement
Pneumococcus
42
[Diagnosis] Fever, cough, colds, wheezing stridor, tachycardia CXR: lobar consolidation
Pneumococcus
43
[Diagnosis] Fever, cough, colds, wheezing stridor, tachycardia CXR: hyperinflation with bilateral interstitial infiltrates and peribronchial cuffing
RSV
44
[Diagnosis] Fever, cough, colds, wheezing stridor, tachycardia CXR: Prominent areas of cavitation and multiple pneumatoceles
Staphylococcus
45
[Diagnosis] Fever, cough, colds, wheezing stridor, tachycardia CXR: right sided hilar adenopathy
Mycobacterium tuberculosis
46
[Diagnosis] High fever, in distress, acutely ill, brassy cough, copious purulent sputum CXR: Ragged air column sign / pseudomembrane detachment in the trachea
bacterial tracheitis
47
[Types of Cough] Staccato
Chlamydia
48
[Types of Cough] Brassy
Staphylococcus
49
[Types of Cough] Barking seal
Parainfluenza
50
[Types of Cough] Whooping posttussive vomiting
Bordetella
51
[Types of Cough] Most severe in the morning
Asthma
52
[Types of Cough] With vigorous exercise
Exercise-induced asthma
53
[Types of Cough] Disappears with sleep
Habit cough
54
[Types of Cough] Tight sounding with wheezing
Asthma
55
What is the primary site of obstruction in Acute Infectious Laryngitis?
Subglottic area
56
Tuberculin sensitivity develops ___ after its administration on the forearm
72 hours
57
[TB classification] (+) exposure (-) PPD
TB exposure
58
[TB classification] (+) exposure (+) PPD
TB infection
59
[TB classification] What are the criteria ti diagnose TB disease
3 or more of 1. Exposure 2. (+) PPD 3. SSx suggestive of TB 4. Abnormal chest xray findings 5. Lab findings
60
[PPD interpretation] >10mm no exposure
Postive
61
[PPD interpretation] >5mm with close contact to known case, clinically suggestive of TB, CXR findingssuggestiv of TB, ICC
Positive
62
[TB Medications] What is the dose of INH
10mg/kg/day PO
63
[TB Medications] What is the dose of Rfampicin
15mg/kg/day PO
64
[TB Medications] What is the dose of pyrazinamide
25mg/kg/day
65
[TB Medications] what is the dose of ethambutol
15mg/kg/day
66
[TB Medications] What is the dose of streptomycin
Im 20-40mg IM OD
67
[DOH TB Treatment Regimens] Cat I
2HRZE | 4HR
68
[DOH TB Treatment Regimens] Cat Ia
2HRZE | 10HR
69
[DOH TB Treatment Regimens] Cat II
2HRZES 1HRZE 5HRE
70
[DOH TB Treatment Regimens] Cat III
2HRZES 1HRZE 9HRE
71
[Discontinuing TB medications] When will you discontinue INH and RIF
1. ALT/AST is more that 3-5x the normal values
72
What are the indicators for pneumonia in a 3 month to 5 years old?
Tachypnea or retractions
73
What are the indicators for pneumonia in 5 to 12 years old?
1. Fever 2. tachypnea 3. crackles
74
[Etiology of pneumonia] 0-28 days
1. E. coli 2. Listeria 3. S. pneumoniae
75
[Etiology of pneumonia] 3 weeks to 3 months
1. RSV 2. Parainfluenzae 3. Chlamydia 4. Mycoplasma 5. S. pneumoniae
76
[Etiology of pneumonia] 4months to 5 years old
1. Viruses 2. S. pneumoniae 3. H. influenzae type B 4. Mycoplasma
77
[Etiology of pneumonia] 5 to 15 years old
1. Mycoplasma | 2. S. pneumoniae
78
[Drugs for pCAP] DOC for pCAP A and B
Oral amoxicillin
79
[Drugs for pCAP] DOC for pCAP C, no previous antibiotic use, complete HiB
Penicillin G
80
[Classify pneumonia] Dehydration: mild Malnutrition: none Pallor: none ``` Retraction: none Head bobbing: none Cyanosis: none Grunting: none Apnea: none Sensorium: none ```
pCAP B
81
[Classify pneumonia] Dehydration: moderate Malnutrition: moderate Pallor: present ``` Retraction: IC/subcostal Head bobbing: present Cyanosis: present Grunting: none Apnea: none Sensorium: irritable ```
pCAP C Admit to ward
82
[Classify pneumonia] Dehydration: severe Malnutrition: severe Pallor: severe ``` Retraction: supraclavicular Head bobbing: present Cyanosis: present Grunting: present Apnea: present Sensorium: lethargic/stuporous ```
pCAP D Admit to ICU
83
[Classify pneumonia] Cough wheezing, stridor, CXR: diffuse, streaky infiltrates CBC: Lymphocytosis
Viral
84
[Classify pneumonia] Cough, high fever, dyspnea, dullness to percussion CXR: lobar pneumonia CBC: neutrophilia
Bacterial Tx: 1. If 0-2 mos Ampicillin + Aminoglycosides 2. If 2mos-5years Ceftriaxone or Cefuroxime + Ampicillin or Amoxiclav
85
[Classify pneumonia] Less ill-looking, non-productive cough CXR: Interstitial pattern, lower lobes
Mycoplasma Tx: 1. If >5 years old, Erythromycin, Clarithromycin, Azithromycin
86
[Classify pneumonia] 6 weeks to 6 months old Staccato cough maternal history of infection CXR: hyperinflation, ground glass appearance CBC: eosinophilia
Erythromycin PO x 14 days
87
Most common etiology of peritonsillar abscess
GAS and anaerobes
88
[Diagnosis] 3-4 years old; M>F Drooling, neck held in hyperextension, bulging of the posterior pharyngeal wall, neck pain, muffled voice, respiratory distress
Retropharyngeal abscess Tx: 1. 3rd gen cephalosporin with Ampicillin-Sulbactam OR Clindamycin

Pediatrics (15 decks)

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